C.Breast – feeding constipation: This can result in bowel movements as infrequent as every 5-7 days. These infants are usually growing well and having soft normal stools and no abdominal distention. Parental reassurance is what is only required. If, however, the infant does not grow, problems in lactation must be assessed and treated. If the problems cannot be corrected, supplementation is indicated.
D. Barium enema: Is indicated in all infants who present with delayed passage of meconium >48 hrs in the neonatal period, constipation during early infancy often associated with abdominal distention and obstructive symptoms. This will identify nearly 80% of the cases of Hirshsprung’s disease, while Rectal Biopsy and manometric studies will confirm the diagnosis.
E. Management of infants with constipation: Consider Diet modification when the Growth is normal. This includes extra water feeds. The addition of cereals, fruits, and vegetables after 3-5 months often improves constipation (proper weaning advice).
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